Backup Documents 09/15/2009 Item #16D18
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 D 1
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 8
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper Attach to origiral document. Original documents should be hand delivered to the Board Otlice. The completed routing slip and original
documents are to be forwarded to the Board Office only after the Board has taken action on the item.)
ROUTING SLIP
Complete routing lines #1 through 114 as appropriate for additional signatures, dates. and/or information needed. If the document is already complete with the
exception of the Chairman's signature, draw a line through routing lines # I through #4, complete the checklist, and forward to Sue Filson (line #5).
Route to Addressee(s) Office Initials Date
(List in routing order)
1. Debbi Maxon Housing and Human Services ~ 9/15/09
2. Donna Fiala, Chaimlan Board of County Commissioners
3.
4.
5. Ian Mitchell, Executive Manage Board of County Commissioners iL '/rlQ!6J
6. Minutes and Records Clerk of Court's Office
PRIMARY CONTACT INFORMATION
(The primary contact is the holder of the original document pending BCC approval. Normally the primary contact is the person who created/prepared the executive
summary. Primary contact information is needed in the event one of the addressees above, including Sue Filson, need to contact staff for additional or missing
information. All original document~ needing the Bce Chairman's signature are to be delivered to the Bee office only after the BCC has acted to approve the
item.)
Name of Primary Staff Debbi Maxon Phone Number 252-2695
Contact Case Manager II
Agenda Date Item was September 15,2009 Agenda Item Number 16Dl8
Approved by the BCC
Type of Document ARRA Contract Amendment 203,9 Number of Original 3
Attached Documents Attached
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark "N/ A" in the Not Applicable column, whichever is Yes N/A (Not
a ro riate, (Initial) Applicable)
1. Original document has been signed/initialed for legal sufficiency. (All documents to be
signed by the Chairman, with the exception of most letters, must be reviewed and signed
by the Office of the County Attorney. This includes signature pages from ordinances,
resolutions, etc. signed by the County Attorney's Office and signature pages from ~
contracts, agreements, etc. that have been fully executed by all parties except the BCC
Chairman and Clerk to the Board and ossibly State Officials.)
2. All handwritten strike-through and revisions have been initialed by the County Attorney's ~
Office and all other aJ1ies exce t the BCC Chairman and the Clerk to the Board
3. The Chairman's signature line date has been entered as the date ofBCC approval of the ~
document or the final ne otiated contract date whichever is applicable.
4. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's Dr-.
si nature and initials are re uired.
5. In most cases (some contracts are an exception), the original document and this routing slip
should be provided to Sue Filson in the Bee office within 24 hours of Bee approval. i1r-
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCe's actions are nullified. Be aware of your deadlines!
6. The document was approved by the BCC on 9/15/09 (enter date) and all changes J:h....
made during the meeting have been incorporated in the attached document. The
Count Attorne 's Office has reviewed the chan es, if a Iicable.
I: Forms! County Forms! Bee Forms! Original Documents Routing Slip wws Original 90304, Revised 1.26.05, Revised 2.24.05
16D18
MEMORANDUM
Date: September 17, 2009
To: Debbie Maxon, Case Manager
Housing & Human Services
From: Teresa Polaski, Deputy Clerk
Minutes and Records Department
Re: ARRA Contract Amendment 203.9
Enclosed are three (3) sets of each agreement, referenced above (Agenda
Item #16Dlt) approved by the Board of County Commissioners on
Tuesday, September 15,2009.
After further processin2 please forward a fullv executed ori2inal to the
Minutes and Records Department for the Board's Records.
If you should have any questions, you may contact me at 252-8411.
Thank you.
Enclosures (3)
16D18
Amendment #001 Contract ARRA 203.09
,
STANDARD CONTRACT
AREA AGENCY ON AGING
Collier County Housing and Human Services.
This AMENDMENT, entered into by the Area Agency on Aging for Southwest Florida, Inc.,
hereinafter referred to as the "agency", and Collier County Housine: and Human Services.
hereinafter referred to as the "recipient", amends agreement # ARRA 203.09.
The purpose of this amendment is to amend the contract amount. The C 1 allocation increased
by $31,731.66 and the C2 allocation increased by $19,878.30.
This amendment shall be effective on August 1, 2009. All provisions in the agreement and any
attachments thereto in conflict with this amendment shall be and are hereby changed to conform
with this amendment.
All provisions not in conflict with this amendment are still in effect and are to be performed at
the level specified in the agreement.
This amendment and all of its attachments are hereby made a part of this agreement.
IN WITNESS WHEREOF, the parties hereto have caused this 2 page amendment to be executed
by their officials there unto duly authorized.
. \ , RECIPIENT:
',\ "
, ' "
)\TTESJ;: , COLLIER COUNTY HOUSING
DWI T E. BROCK, Clerk AND HUMAN SERVICES
i',
. ,-'" ~~c.
By:
, . ~.,
Attett II~ to c-............ . TV COMMI:;2:ERS
, 1 tftatllf':t Oft"
, Y, FLORIDA _
Approved as to form and By: ~ ("-:,l-~
legal sufficiency: DONNA FIALA, CHAIRMAN
O~~ Date: September 15.2009
-
Assistant County Attorney
AGENCY: AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA, INe. .. .. . . .. .. .. .. .
.. .. .. .. .. .. .. .. ..
.. .. . .. . .. .. .. ..
.. . .. .. .. .. .. .. ..
.. .. .. .. .. .. .. .. ..
.. .. .. .. .. .. .. .. ..
SIGNED BY: .. .. .. .. .. .. .. .. ..
~.
... ............
. .
NAME: Naomi Manning . .
.... ............
TITLE: Board President .. .... ..........
.. .. .. .. .. .. .. .. ..
.. .. .. .. .. .. .. .. ..
DATE: .. .. .. .. .. .. .. .. ..
.. .. .. .. .. .. .. .. ..
.. .. .. .. .. .. .. .. ..
FEDERAL ID NUMBER: 59-6000558 .. .. .. .. .. .. .. .. ..
- - - .. . ..
FISCAL YEAR-END DATE: 9/30
1
Amendment #001 Conn-act ARRA 2030916 D 18
ATTACHMENT III
EXHffiIT -1
I. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS
CONSIST OF THE FOLLOWING:
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
Pro2l'8lJ1 Title Funding Source CFDA/CSF A Amount
Title III CI (ARRA)Congregate U.S. Health and Human 93.707
Meals Services $80,755.38
Title III C2 (ARRA) Horne U.S. Health and Human 93.705
Delivered Meals Services $39,756.42
TOTAL FEDEKM.. AWARD: $120,511.80
COMPLIANCE REQUIREMENTS APPLICABLE TO mE FEDERAL RESOURCES
AWARDED PURSUANT TO TIDS AGREEMENT ARE AS FOLLOWS:
ATTACHMENT VII
AMERICAN RECOVERY AND REINVESTMENT ACT
THREE MONm BUDGET SUMMARY
RECIPIENT: Collier County Board of County Commissioners
I. C I Congregate Meals $ 80,755.38
2. C2 Horne Delivered Meals $ 39,756.42
TOTAL $ 120,511.80
2
16D 18
Attestation Statement
Agreement/Contract Number ARRA 203.09
Amendment Number 001
I, Donna Fiala. Chairman, attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on
Aging and
Collier Countv Board of County Commissioners
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting, due to the differences
in electroni a p"",esslng ]: Wh~Ch has no affect on the agreemenllcontract content.
~ ~ Seotember 15.2009
Signature of Recipient/Contractor representative Date
Ms~!!!t.~::~
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. . . . . .
==Z- DOEA Contract Manager to initial and date indicating signatures/initials appropriate on all
. . . . . .
.. ...
documents; ready for DOE A Secretary/designee signature
initial date
.. ...
.. ...
. . . . . .
. . . . .
.. . . -
Revised August 2007
Amendment #001 Contract ARRA 203.09 1 6 D 1 8
STANDARD CONTRACT
AREA AGENCY ON AGING
Collier County Housing and Human Services.
This AMENDMENT, entered into by the Area Agency on Aging for Southwest Florida, Inc.,
hereinafter referred to as the "agency", and Collier County Housine: and Human Services.
hereinafter referred to as the "recipient", amends agreement # ARRA 203.09.
The purpose of this amendment is to amend the contract amount. The C 1 allocation increased
by $31,731.66 and the C2 allocation increased by $19,878.30.
This amendment shall be effective on August 1, 2009. All provisions in the agreement and any
attachments thereto in conflict with this amendment shall be and are hereby changed to conform
with this amendment.
All provisions not in conflict with this amendment are still in effect and are to be performed at
the level specified in the agreement.
This amendment and all of its attachments are hereby made a part of this agreement.
IN WITNESS WHEREOF, the parties hereto have caused this ~ page amendment to be executed
by their officials there unto duly authorized.
RECIPIENT:
A TJ'Jsr~ ,:: -'J''', COLLIER COUNTY HOUSING
D'WIGItt'E':B~Qr;K, Clerk AND HUMAN SERVICES
'~.,,~~
.:.. ',; , ' "'J:~'~..b( By:
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Approved1lifto form and By:
legal sufficiency:
Date: September 15.2009
Assistant County Attorney
AGENCY: AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA, INC.
. : . : . : . : . . . . . . . . . .
SIGNED BY: :<<<<:::-:-:-:
. . " '"
NAME: Naomi Manning ~.:
TITLE: Board President ~.:
DATE: ...... ...........
FEDERAL ID NUMBER: 59-6000558 . . . . . . : . : . : . . . . . . . I
FISCAL YEAR-END DATE: 9/30 . . . . . . . . . . . . : . : . : .
1
Contract ARRA 203.09 16D18
Amendment #001
ATTACHMENT ill
EXHIBIT -1
1. FEDERAL RESOURCES AWARDED TO THE SUB RECIPIENT PURSUANT TO THIS
CONSIST OF THE FOLLOWING:
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
Program Title Fundin11; Source CFDA/CSF A Amount
Title III Cl (ARRA)Congregate U.S. Health and Human 93.707
Meals Services $80,755.38
Title III C2 (ARRA) Home U.S. Health and Human 93.705
Delivered Meals Services $39,756.42
TOTAL FEDERAL AWARD: $120,511.80
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES
AWARDED PURSUANT TO TIDS AGREEMENT ARE AS FOLLOWS:
ATTACHMENT VII
AMERICAN RECOVERY AND REINVESTMENT ACT
THREE MONTH BUDGET SUMMARY
RECIPIENT: Collier County Board of County Commissioners
1. C 1 Congregate Meals $ 80,755.38
2. C2 Home Delivered Meals $ 39,756.42
TOTAL $ 120,511.80
2
16D 18
Attestation Statement
Agreement/Contract Number ARRA 203.09
Amendment Number 001
I, Donna Fiala. Chairman, attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on
Aging and
Collier County Board of County Commissioners
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting, due to the differences
: . : . : . . . : . : . : . in electrDnic data processing media, which has no affect on the agreement/contract content.
. . . . . . .
. .. ...
. : : : : :Signature of Recipient/Contractor representative September 15. 2009
Date
. . .
'.:.:.:':.:.: .
~)Jrf!2u
Assistant County Attorney
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(~1"1 . [} Ll ::.' ~. '.;"
DOEA Contract Manager to initial and date indicating signatures/initials appropriate on all
documents; ready for DOEA Secretary/designee signature
initial date
Revised August 2007
Amendment #001 Contract ARRA 203.09 1 6 D 1 8
,
STANDARD CONTRACT
AREA AGENCY ON AGING
Collier County Housing and Human Services.
This AMENDMENT, entered into by the Area Agency on Aging for Southwest Florida, Inc.,
hereinafter referred to as the "agency", and Collier County Housine: and Human Services.
hereinafter referred to as the "recipient", amends agreement # ARRA 203.09.
The purpose of this amendment is to amend the contract amount. The C 1 allocation increased
by $31,731.66 and the C2 allocation increased by $19,878.30.
This amendment shall be effective on August 1, 2009. All provisions in the agreement and any
attachments thereto in conflict with this amendment shall be and are hereby changed to conform
with this amendment.
All provisions not in conflict with this amendment are still in effect and are to be performed at
the level specified in the agreement.
This amendment and all of its attachments are hereby made a part of this agreement.
IN WIlNESS WHEREOF, the parties hereto have caused this ~ page amendment to be executed
by their officials there unto duly authorized.
f'; RECIPIENT:
COLLIER COUNTY HOUSING
AND HUMAN SERVICES
. B : C By:
-.
,. It ..;~'e..,..,..
.. " . . . BOARD OF C
~ .J....,....: fill),. COLLIER CO
" ' (.)/'. .>:
By:
Date: September 15.2009
AGENCY: AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA, INC. . - ~ . - . .
. . . . . . .
SIGNED BY:
NAME: Naomi Manning
TITLE: Board President
DATE:
FEDERAL ID NUMBER: 59-6000558 . . . . . . .
FISCAL YEAR-END DATE: 9/30 . . . . . . .
. . . . . . .
1
Amendment #001 Contract ARRA 203.09 !6D18
ATTACHMENT ill
EXlDBIT -1
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS
CONSIST OF THE FOLLOWING:
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
PrOgram Title Funding Source CFDA/CSF A Amount
Title III Cl (ARRA)Congregate U.S. Health and Human 93.707
Meals Services $80,755.38
Title III C2 (ARRA) Home U.S. Health and Human 93.705
Delivered Meals Services $39,756.42
TOTAL FEDERAL AWARD: $120,511.80
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES
AWARDED PURSUANT TO TIllS AGREEMENT ARE AS FOLLOWS:
ATTACHMENT VII
AMERICAN RECOVERY AND REINVESTMENT ACT
THREE MONTH BUDGET SUMMARY
RECIPIENT: Collier County Board of County Commissioners
1. C 1 Congregate Meals $ 80,755.38
2. C2 Home Delivered Meals $ 39,756.42
TOTAL $ 120,511.80
2
16018
Attestation Statement
Agreement/Contract Number ARRA 203.09
Amendment Number 001
I, Donna Fiala. Chairman, attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on
Aging and
Collier County Board of County Commissioners
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting, due to the differences
. . . . . . . . . . . . . . . . " in electronic data processing media, which has no affect on the agreement/contract content.
:::::::::::::::::'
:~ September 15.2009
. : . : . . . . '. ...... Signature of Recipient/Contractor representative Date
:::::::::::::::::
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DOEA Contract Manager to initial and date indicating signatures/initials appropriate on all
documents; ready for DOEA Secretary/designee signature
initial date
Revised August 2007